The Psychopath Inside

This book is equal parts memoir and advanced education in brain chemistry and function. Neuroscientist James Fallon takes the reader through his slow realization over several decades that he is in fact a ‘Psychopath Lite’.

The story is fascinating, following his childhood, adolescence, young adulthood, and even into the mature years of his career. He manages to win you over with wit, charm, and self-disclosure, all while admitting he doesn’t concern himself too much with the welfare of individuals in his life. Humanity? Yes. He believes in several good causes, and invests significant time in anonymous and unpaid service. But individuals? Closest friends? Wife and Kids? He tries, now that he knows how it matters, but he’s going through the motions, and it does not come naturally. He gets a kick out of harmless manipulation, and feels nothing when he’s genuine and sensitive. You see, the part of his brain that would reward him for empathetic behavior is turned off.

HE DIDN’T KNOW. He honestly thought he was a normal, well-adjusted guy with an average brain who loved his wife and kids and contributed to society. He was sometimes mystified by people who cried, or the sense of dualism some people talked about when they compared the feeling of the outer real world with their inner thinking/feeling world, but he didn’t worry too much about that. He was popular, and while he could sweet talk his way out of anything, he followed a moral code that kept his mischievousness harmless. He pulled pranks, but never intentionally hurt anyone, and made sure it ended all in good fun.

Since he’s a brain scientist, Dr. Daniel Amen had asked him to study a brain scan collection of convicted murderers. James found a very convincing pattern that made perfect sense for psychopaths. Then, in another Alzheimer study, he’d scanned his own brain, and noticed it carried the same psychopath pattern he’d just discovered.

He wasn’t worried.

Then, his mother pointed him to family history, where there were generations of his ancestors who killed their own family members in brutal ways from the 17th through 19th centuries, and even further back, regal examples (Kind John Lackland, Henry II, III, and Edward I) that included really well documented examples of psychopath behavior.

He wasn’t worried.

Then, he got genetic screening, and the marker for aggressive tendencies came back positive. But, since he wasn’t actually aggressive (outside of sore-loser stonewalling after a Scrabble game), he wasn’t worried.

He didn’t worry, because if he were a full-blown psychopath, he’d have done something horrible by now, and he hadn’t. But why hadn’t he?

He came to realize the only major indicator for psychopathy he didn’t have was an abusive childhood. He had had a happy childhood. And he came to realize how close he had come to a life as a mafia boss or inner city gang leader. Abuse would have triggered that path, cutting him off from his last hope for decency; the philosophical concern for other human beings he managed to gain from his nurturing upbringing.

Psychopath and sociopath are not actually universally accepted diagnoses, and even for professionals who use the term, they understand they come in a lot of different varieties.

What are the terms James Fallon used? He started with the closest official version, antisocial personality disorder, which he admits is not even exactly the same. The Diagnostic and Statistical Manual of Mental Disorders (a.k.a. the DSM) describes APD as a ‘pervasive pattern of disregard for and violation of the rights of others that has been occurring in the person since the age of 15 years, as indicated by three or more of seven criteria: 1. A failure to conform to social norms 2. Irresponsibility 3. Deceitfulness 4. Indifference to the welfare of others 5. Recklessness 6. Failure to plan ahead 7. Irritability and aggressiveness.’

There is a Psychopathy Checklist that can be carefully administered by a team of professionals and character witnesses (remember the penchant for deceitfulness). Like a lot of disorders, it’s on a spectrum. A score of 40 is full-blown. 25–30 is the cutoff for official diagnosis. James suspects Psychopath Lites like him (and the Will Graham character from Manhunter) would score between 15 and 23.

Psychopathy also comes in different flavors. James’ flavor is friendly, yet egotistical, risk-taking, unreliable, and inconsiderate. Which of those 7 criteria apply to any individual customizes the Psychopathy. His flavor seems to me the nicest way to be a Psychopath Lite, if you are going to be one at all. But I still wouldn’t trust him farther than I could throw him.